- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,319.90 / $23,473.30 / $30,647.70
| Facility | | $11,319.90 | $23,473.30 | $30,647.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,435.96 / $57,401.30
| Facility | | $5,840.42 | $21,435.96 | $57,401.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,263.21 / $21,931.00 / $33,138.01
| Facility | | $13,263.21 | $21,931.00 | $33,138.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,144.28 / $31,144.28 / $31,144.28
| Facility | | $31,144.28 | $31,144.28 | $31,144.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,109.68 / $22,093.51 / $34,117.57
| Facility | | $19,109.68 | $22,093.51 | $34,117.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,435.96 / $57,401.30
| Facility | | $5,840.42 | $21,435.96 | $57,401.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,435.96 / $44,859.62
| Facility | | $5,840.42 | $21,435.96 | $44,859.62 |